The Postmodernist Critique of Evidence-Based Practice

In this paper, we examine the postmodernist argument that evidence-based practice (EBP) should be rejected by nurses because it restricts the sources of knowledge used by practitioners. Three main postmodernist criticisms are identified and discussed. First, that the notion of ‘best evidence’ implies a hierarchical and exclusivist approach to knowledge. We accept this argument, noting that such a hierarchy is accepted and justified by many of its proponents. Second, that the hierarchy embraced by the evidence-based practice movement damages health care because it excludes other forms of evidence that are needed to understand the complexity of care. We accept that some manifestations of EBP, notably the Cochrane Collaboration, have devalued qualitative evidence. Using our previous experience of conducting Cochrane reviews (McGaughey et al. 2007), we argue that this limits explanatory scope. Third, that it fails to take account of individuals or their experience. Here, we use evidence of the use by midwives of EBP policies and protocols to the detriment of including women in decision-making processes (Porter et al. 2007) to accept that there is also some merit to this critique. We conclude that, while it is not necessary to concur with the total rejection of EBP that postmodernists advocate, it is necessary to address the issues they raise in order to ensure that EBP better fits the requirements of nursing.
McGaughey, J., Alderdice, F., Fowler, R., Kapila, A., Mayhew, A., Moutray, M., 2007. Outreach and Early Warning Systems (EWS) for the prevention of Intensive Care admission and death of critically ill adult patients on general hospital wards. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD005529. DOI: 10.1002/14651858.CD005529.pub2.
Porter, S., Crozier, K., Sinclair, M., Kernohan, W., 2007. New midwifery? A qualitative analysis of midwives’ decision-making strategies. Journal of Advanced Nursing 60 (6), 525-534.

Criticality, factorization, and long-range correlations in the anisotropic XY model

We study the long-range quantum correlations in the anisotropic XY model. By first examining the thermodynamic limit, we show that employing the quantum discord as a figure of merit allows one to capture the main features of the model at zero temperature. Furthermore, by considering suitably large site separations we find that these correlations obey a simple scaling behavior for finite temperatures, allowing for efficient estimation of the critical point. We also address ground-state factorization of this model by explicitly considering finite-size systems, showing its relation to the energy spectrum and explaining the persistence of the phenomenon at finite temperatures. Finally, we compute the fidelity between finite and infinite systems in order to show that remarkably small system sizes can closely approximate the thermodynamic limit.

Predominance of entanglement of formation over quantum discord under quantum channels

We present a study of the behavior of two different figures of merit for quantum correlations, entanglement of formation and quantum discord, under quantum channels showing how the former can, counterintuitively, be more resilient to such environments spoiling effects. By exploiting strict conservation relations between the two measures and imposing necessary constraints on the initial conditions we are able to explicitly show this predominance is related to build-up of the system-environment correlations.

Intensive temperature and quantum correlations for refined quantum measurements

We consider the concept of temperature in a setting beyond the standard thermodynamics prescriptions. Namely, rather than restricting to standard coarse-grained measurements, we consider observers able to master any possible quantum measurement -a scenario that might be relevant at nanoscopic scales. In this setting, we focus on quantum systems of coupled harmonic oscillators and study the question of whether the temperature is an intensive quantity, in the sense that a block of a thermal state can be approximated by an effective thermal state at the same temperature as the whole system. Using the quantum fidelity as figure of merit, we identify instances in which this approximation is not valid, as the block state and the reference thermal state are distinguishable for refined measurements. Actually, there are situations in which this distinguishability even increases with the block size. However, we also show that the two states do become less distinguishable with the block size for coarse-grained measurements -thus recovering the standard picture. We then go further and construct an effective thermal state which provides a good approximation of the block state for any observables and sizes. Finally, we point out the role that entanglement plays in this scenario by showing that, in general, the thermodynamic paradigm of local intensive temperature applies whenever entanglement is not present in the system. Copyright (C) EPLA, 2012

Coherently Opening a High-Q Cavity

We propose a general framework to effectively `open' a high-Q resonator, that is, to release the quantum state initially prepared in it in the form of a traveling electromagnetic wave. This is achieved by employing a mediating mode that scatters coherently the radiation from the resonator into a one-dimensional continuum of modes such as a waveguide. The same mechanism may be used to `feed' a desired quantum field to an initially empty cavity. Switching between an `open' and `closed' resonator may then be obtained by controlling either the detuning of the scatterer or the amount of time it spends in the resonator. First, we introduce the model in its general form, identifying (i) the traveling mode that optimally retains the full quantum information of the resonator field and (ii) a suitable figure of merit that we study analytically in terms of the system parameters. Then, we discuss two feasible implementations based on ensembles of two-level atoms interacting with cavity fields. In addition, we discuss how to integrate traditional cavity QED in our proposal using three-level atoms.

Effective cutting of a quantum spin chain by bond impurities

Spin chains are promising media for short-haul quantum communication. Their usefulness is manifested in all those situations where stationary information carriers are involved. In the majority of the communication schemes relying on quantum spin chains, the latter are assumed to be finite in length, with well-addressable end-chain spins. In this paper we propose that such a configuration could actually be achieved by a mechanism that is able to effectively cut a spin ring through the insertion of bond defects. We then show how suitable physical quantities can be identified as figures of merit for the effectiveness of the cut. We find that, even for modest strengths of the bond defect, a ring is effectively cut at the defect site. In turn, this has important effects on the amount of correlations shared by the spins across the resulting chain, which we study by means of a scattering-based mechanism of a clear physical interpretation. © 2013 American Physical Society.

High-Efficiency Harmonic-Peaking Class-EF Power Amplifiers with Enhanced Maximum Operating Frequency

The recently introduced Class-EF power amplifier (PA) has a peak switch voltage lower than that of the Class-E PA. However, the value of the transistor output capacitance at high frequencies is typically larger than the required Class-EF optimum shunt capacitance. Consequently, soft-switching operation that minimizes power dissipation during off-to-on transition cannot be achieved at high frequencies. Two new Class-EF PA variants with transmission-line load networks, namely, third-harmonic-peaking (THP) and fifth-harmonic-peaking (FHP) Class-EF PAs are proposed in this paper. These permit operation at higher frequencies at no expense to other PA figures of merit. Analytical expressions are derived in order to obtain circuit component values, which satisfy the required Class-EF impedances at fundamental frequency, all even harmonics, and the first few odd harmonics as well as simultaneously providing impedance matching to a 50- Ω load. Furthermore, a novel open-circuit and shorted stub arrangement, which has substantial practical benefits, is proposed to replace the normal quarter-wave line connected at the transistor's drain. Using GaN HEMTs, two PA prototypes were built. Measured peak drain efficiency of 91% and output power of 39.5 dBm were obtained at 2.22 GHz for the THP Class-EF PA. The FHP Class-EF PA delivered output power of 41.9 dBm with 85% drain efficiency at 1.52 GHz.

Neuropeptides in Helminths: Occurrence and Distribution

Nematode neuropeptide systems comprise an exceptionally complex array of similar to 250 peptidic signaling molecules that operate within a structurally simple nervous system of similar to 300 neurons. A relatively complete picture of the neuropeptide complement is available for Caenorhabditis elegans, with 30 flp, 38 ins and 43 nlp genes having been documented; accumulating evidence indicates similar complexity in parasitic nematodes from clades I, III, IV and V. In contrast, the picture for parasitic platyhelminths is less clear, with the limited peptide sequence data available providing concrete evidence for only FMRFamide-like peptide (FLP) and neuropeptide F (NPF) signaling systems, each of which only comprises one or two peptides. With the completion of the Schmidtea meditteranea and Schistosoma mansoni genome projects and expressed sequence tag datasets for other flatworm parasites becoming available, the time is ripe for a detailed reanalysis of neuropeptide signaling in flatworms. Although the actual neuropeptides provide limited obvious value as targets for chemotherapeutic-based control strategies, they do highlight the signaling systems present in these helminths and provide tools for the discovery of more amenable targets such as neuropeptide receptors or neuropeptide processing enzymes. Also, they offer opportunities to evaluate the potential of their associated signaling pathways as targets through RNA interference (RNAi)-based, target validation strategies. Currently, within both helminth phyla, the flp signaling systems appear to merit further investigation as they are intrinsically linked with motor function, a proven target for successful anti-parasitics; it is clear that some nematode NLPs also play a role in motor function and could have similar appeal. At this time, it is unclear if flatworm NPF and nematode INS peptides operate in pathways that have utility for parasite control. Clearly, RNAi-based validation could be a starting point for scoring potential target pathways within neuropeptide signaling for parasiticide discovery programs. Also, recent successes in the application of in planta-based RNAi control strategies for plant parasitic nematodes reveal a strategy whereby neuropeptide encoding genes could become targets for parasite control. The possibility of developing these approaches for the control of animal and human parasites is intriguing, but will require significant advances in the delivery of RNAi-triggers.

Out-of-equilibrium thermodynamics of quantum optomechanical systems

We address the out-of-equilibrium thermodynamics of an isolated quantum system consisting of a cavity optomechanical device. We explore the dynamical response of the system when driven out of equilibrium by a sudden quench of the coupling parameter and compute analytically the full distribution of the work generated by the process. We consider linear and quadratic optomechanical coupling, where the cavity field is parametrically coupled to either the position or the square of the position of a mechanical oscillator, respectively. In the former case we find that the average work generated by the quench is zero, whilst the latter leads to a non-zero average value. Through fluctuations theorems we access the most relevant thermodynamical figures of merit, such as the free energy difference and the amount of irreversible work generated. We thus provide a full charac- terization of the out-of-equilibrium thermodynamics in the quantum regime for nonlinearly coupled bosonic modes. Our study is the first due step towards the construction and full quantum analysis of an optomechanical machine working fully out of equilibrium.

Knowledge translation in men’s health research: development and delivery of content for use online

Background: Men can be hard to reach with face-to-face health-related information, while increasingly, research shows that they are seeking health information from online sources. Recognizing this trend, there is merit in developing innovative online knowledge translation (KT) strategies capable of translating research on men’s health into engaging health promotion materials. While the concept of KT has become a new mantra for researchers wishing to bridge the gap between research evidence and improved health outcomes, little is written about the process, necessary skills, and best practices by which researchers can develop online knowledge translation.
Objective: Our aim was to illustrate some of the processes and challenges involved in, and potential value of, developing research knowledge online to promote men’s health.

Methods: We present experiences of KT across two case studies of men’s health. First, we describe a study that uses interactive Web apps to translate knowledge relating to Canadian men’s depression. Through a range of mechanisms, study findings were repackaged with the explicit aim of raising awareness and reducing the stigma associated with men’s depression and/or help-seeking. Second, we describe an educational resource for teenage men about unintended pregnancy, developed for delivery in the formal Relationship and Sexuality Education school curricula of Ireland, Northern Ireland (United Kingdom), and South Australia. The intervention is based around a Web-based interactive film drama entitled “If I Were Jack”.

Results: For each case study, we describe the KT process and strategies that aided development of credible and well-received online content focused on men’s health promotion. In both case studies, the original research generated the inspiration for the interactive online content and the core development strategy was working with a multidisciplinary team to develop this material through arts-based approaches. In both cases also, there is an acknowledgment of the need for gender and culturally sensitive information. Both aimed to engage men by disrupting stereotypes about men, while simultaneously addressing men through authentic voices and faces. Finally, in both case studies we draw attention to the need to think beyond placement of content online to delivery to target audiences from the outset.

Conclusions: The case studies highlight some of the new skills required by academics in the emerging paradigm of translational research and contribute to the nascent literature on KT. Our approach to online KT was to go beyond dissemination and diffusion to actively repackage research knowledge through arts-based approaches (videos and film scripts) as health promotion tools, with optimal appeal, to target male audiences. Our findings highlight the importance of developing a multidisciplinary team to inform the design of content, the importance of adaptation to context, both in terms of the national implementation context and consideration of gender-specific needs, and an integrated implementation and evaluation framework in all KT work.

Bone tool analysis

This article examines the osseous technologies that can be created from animal skeletons. 'Tool' status is accorded to a skeletal element or fragment that has been modified subsequent to its isolation from the carcass. Such anthropic adaptation may be deliberate (e.g., through manufacture) and/or appear as a result of utilization, and is granted in instances where these details cannot otherwise be ascribed to alternative nonanthropic causes. Implements can display a combination of traces from both human and natural sources and as such the study of them involves both zooarchaeological (i.e., via animal ecology, hunting, and butchery) and technological analysis.... As an exemplar of this, the following discussion will present some of the similarities and differences that exist between osseous and lithic raw materials and tool-blank production, and will situate both in an operational sequence of animal procurement and processing. It will then give an account of principal manufacturing techniques, methods for establishing tool function, and the phenomenon of 'pseudo tools'. © 2008 Copyright © 2008 Elsevier Inc.

Cigarette Smoke, Airway Epithelial Cells and Host Defence

In COPD inflammation driven by exposure to tobacco smoke results in impaired innate immunity in the airway and ultimately to lung injury and remodeling. To understand the biological processes involved in host interactions with cigarette derived toxins submerged epithelial cell culture is widely accepted as a model for primary human airway epithelial cell culture research. Primary nasal and bronchial epithelial cells can also be cultured in air-liquid interface (ALI) models. ALI and submerged culture models have their individual merits, and the decision to use either technique should primarily be determined primarily by the research hypothesis.

Cigarette smoke has gaseous and particulate matter, the latter constituent primarily represented in cigarette smoke extract (CSE). Although not ideal in order to facilitate our understanding of the responses of epithelial cells to cigarette smoke, CSE still has scientific merit in airway cell biology research. Using this model, it has been possible to demonstrate differences in levels of tight junction disruption after CSE exposure along with varied vulnerability to the toxic effects of CSE in cell cultures derived from COPD and control study groups.

Primary nasal epithelial cells (PNECs) have been used as an alternative to bronchial epithelial cells (PBECs). However, at least in subjects with COPD, PNECs cannot consistently substitute for PBECs. Although airway epithelial cells from patients with COPD exhibit a constitutional pro-inflammatory phenotype, these cells have a diminished inflammatory response to CSE exposure. COPD epithelial cells have an increased susceptibility to undergo apoptosis, and have reduced levels of Toll-like receptor-4 expression after CSE exposure, both of which may account for the reduced inflammatory response observed in this group.

The use of CSE in both submerged and ALI epithelial cultures has extended our understanding of the cellular mechanisms that are important in COPD, and helped to unravel important pathways which may be of relevance in its pathogenesis.

Limitations of a measurement-assisted optomechanical route to quantum macroscopicity of superposition states

Optomechanics is currently believed to provide a promising route towards the achievement of genuine quantum effects at the large, massive-system scale. By using a recently proposed figure of merit that is well suited to address continuous-variable systems, in this paper we analyze the requirements needed for the state of a mechanical mode (embodied by an end-cavity cantilever or a membrane placed within an optical cavity) to be qualified as macroscopic. We show that, according to the phase space-based criterion that we have chosen for our quantitative analysis, the state achieved through strong single-photon radiation-pressure coupling to a quantized field of light and conditioned by measurements operated on the latter might be interpreted as macroscopically quantum. In general, though, genuine macroscopic quantum superpositions appear to be possible only under quite demanding experimental conditions

The HIF-1alpha C1772T polymorphism may be associated with susceptibility to clinically localised prostate cancer but not with elevated expression of hypoxic biomarkers

We investigated the role of the C1772T polymorphisms in exon 12 of the Hypoxia-inducible factor-1 alpha (HIF-1alpha) gene C1772T genotype in prostate cancer (PCa) and amplification of the hypoxic response. We identified the heterozygous germline CT genotype as an increased risk factor for clinically localised prostate cancer (Odds ratio = 6.2; p < 0.0001). While immunostaining intensity for HIF-1alpha and VEGF was significantly enhanced in 75% of PCa specimens when compared to matched benign specimens (p < 0.0001), the CT genotype did not modulate the kinetics of HIF-1alpha protein expression in hypoxia in vitro, and was not associated with enhanced expression of hypoxic biomarkers. This study provides the first evidence of an increased risk for clinically localised prostate cancer in men carrying the C1772T HIF-1alpha gene polymorphism. Although our results did not suggest an association between expression of hypoxic biomarkers and genotype status, the correlation may merit further investigation.

Effects of scalding and dehairing of pig carcasses at abattoirs on the visibility of welfare-related lesions

There is increasing interest in developing abattoir-based welfare measures for pigs.The primary aim of this study was to determine the most appropriate place on theslaughter line to conduct assessments of welfare-related lesions, namely apparentaggression-related skin lesions (hereafter referred to as 'skin lesions'), loin bruising andapparent tail biting damage. The study also lent itself to an assessment of theprevalence of these lesions, and the extent to which they were linked with productionparameters. Finishing pigs processed at two abattoirs on the Island of Ireland (n =1950 in abattoir A, and n = 1939 in abattoir B) were used. Data were collected over 6days in each abattoir in July 2014. Lesion scoring took place at two points on theslaughter line: (1) at exsanguination (Slaughter Stage 1 [SS1]), and (2) followingscalding and dehairing of carcasses (Slaughter Stage 2 [SS2]). At both points, eachcarcass was assigned a skin and tail lesion score ranging from 0 (lesion absent) to 3 or4 (severe lesions), respectively. Loin bruising was recorded as present or absent.Differences in the percentage of pigs with observable lesions of each type werecompared between SS1 and SS2 using McNemar/McNemar-Bowker tests. Theassociations between each lesion type, and both cold carcass weight andcondemnations, were examined at batch level using Pearson's correlations. Batch wasdefined as the group of animals with a particular farm identification code on a givenday. The overall percentage of pigs with a visible skin lesion (i.e. score > 0) decreasedbetween SS1 and SS2 (P<0.001). However, the percentage of pigs with a severe skinlesion increased numerically from SS1 to SS2. The percentage of pigs with a visible taillesion and with loin bruising also increased between SS1 and SS2 (P<0.001). Therewas a positive correlation between the percentage of carcasses that were partiallycondemned, and the percentage of pigs with skin lesions, tail lesions and loin bruising(P<0.05). Additionally, as the batch-level frequency of each lesion type increased,average cold carcass weight decreased (P<0.001). These findings suggest that severeskin lesions, tail lesions and loin bruising are more visible on pig carcasses after theyhave been scalded and dehaired, and that this is when abattoir-based lesion scoringshould take place. The high prevalence of all three lesion types, and the links witheconomically important production parameters, suggests more research into identifying key risk factors is warranted.